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AlexiaEsq.
AlexiaEsq., Managing Attorney
Category: Employment Law
Satisfied Customers: 11569
Experience:  19+ Years of Legal Practice in the Employment law arena.
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I live in N.M.I am on workers comp since 2/2012.I did work

Customer Question

I live in N.M.I am on worker's comp since 2/2012.I did work until 10/2012 at reduced hours. My company then let me go.My question is in two parts.I had no problems until may when my benefit did not arrive as usual.It took two weeks of talk for them to paid.So when is it time to get a lawyer and what should they be responible for in the long run.
Submitted: 10 months ago.
Category: Employment Law
Expert:  AlexiaEsq. replied 10 months ago.
Hi, my name is XXXXX XXXXX X thank you for your inquiry. I have been practicing Employment law for 19+ years and look forward to assisting you. With regard to your post, if you could clarify:

I live in N.M.I am on worker's comp since 2/2012. OK, so you are receiving what? Wage replacement checks each pay period or each month?


I did work until 10/2012 at reduced hours. Why reduced? Was that a medical need ?

 

My company then let me go. Why did they let you go?

 

My question is in two parts.I had no problems until may Of 2013?

 

when my benefit did not arrive as usual.It took two weeks of talk for them to paid. You mean for YOU to be paid, right? What was the reason for the nonpayment/delayed payment?

 

So when is it time to get a lawyer and what should they be responible for in the long run.What is it you seek from a lawyer that you are not getting right now?

Customer: replied 10 months ago.

I got hurt at work and receive benefit from Gallagher and Bassett every two weeks.It is what is called temperory full benefits.This company is insured by the company I worked for.I was attacked by a patient and my doctor felt due to the injury I received I could not work my regular hours or position.My back and neck were injuried.Carlsbad Medical Hospital [where I worked] stated that I reached by limit of being on leave of absecent.That is not what I was advised by the person at HR who was handling my worker's comp..In May I should of got a check on the 17th and did not so I called and text for two weeks.Then Regina[my rep]stated she did not know why and sent the ckeck.Regina is also a new rep. for me I had a person named Courney prior and never had any problems.I had heard horror stories so when the payment did not come I through I was going to start having problems.I just wanted to know what I guess they can do to me and what my rights are and if this is something I need a lawyer for.I need to be paid to pay my living expensive.I will never work as a staff R.N. again and I am limited by my physical activities of every day life.I also take several pain medication and have started on antidepressants on and off.

Expert:  AlexiaEsq. replied 10 months ago.
Hi, thank you for your follow up and I hope you are enjoying your weekend.

Generally, this is how it works: They continue to pay your lost wage if you are unable to work until they feel you have reached Maximum Medical Improvement. At that point, they stop paying you wages and if you remain unable to return to work, you will want to make a claim for your permanent disability - which can typically be partial or total. It may be partial in that you can still work, just not at your old profession, or it could be total in that you can't work a full day anywhere, in any capacity. I highly recommend you consult with or hire a WC attorney unless you are very well-versed in the charts used to determine which body parts remain disabled, what %'s are applied, and how much cash each one is worth. It is a bit mechanical. But it tends to be that the WC carrier will say you are only suffering a 10% loss of use of back (for instance), while you feel you suffer loss of use of it far more than that. You will need doctors who can describe in WC lingo their findings as to why they believe you are X amount, an amount way higher than 10%. And this can go on for other WC related impairments (i.e. neck, shoulder, mental health, etc.). You will also want to make sure that there is or is not a 3rd party who actually caused your injury that you can sue under "personal injury". If there is no 3rd party implicated (and you likely won't know that one way or another unless you have taken a few WC law classes), then you are stuck with WC remedies only - which are quite devastatingly low for the fully disabled (as opposed to the worker that needed stiches and nothing else). WC remedies do not include your pain, suffering, loss of recreational activities, if any, you used to do, not do they cover your full lost wages. However, a 3rd party PI suit DOES cover those losses - you can't sue your employer for them (double edged sword of the WC law), but you CAN sue a negligent party that is neither your employer or your co-worker, if he caused your injury. For instance, had the hospital hired an outsourced company to provide protection when a patient was dangerous, and if so, did that guard go on an unapproved break when he should have been guarding? Was he (and therefore HIS employer) negligent? Resulting in your injury? That could be a 3rd party in a PI suit. Or, if the doctor was outsourced, who failed to diagnose him as dangerous, possibly a 3rd party (but not a doctor that was an employee of the hospital, typically).

In any event, you generally want to get onto the perm. disability aspect asap because those long term matters can take years. Also, if you are unable to work FT even in a simple sedentary job, due to pain issues or other, you may be eligible for Social Security Disability as well - another often lengthy battle, but like WC, most attorneys work without any retainer, so all can get a lawyer if they need one. You may also have long term disability policy with your employer as a benefit, so check that out as well.

I hope this helps! My goal is to provide you with excellent and accurate service – if you feel you have gotten anything less, please reply back, I am happy to address follow-up questions. Kindly rate me "excellent" when you are done. I look forward to assisting you in the future, should you have legal questions.

Sincerely,

Alexia Esq.

Customer: replied 10 months ago.
I don't know if this is a third party or not but the doctor who was in charge of this patient is not an employee but belongs to a company called epogee group.The reason I mention this is because he refused 4 attempts to give me an order to give the patientIV pain medication which is what she keep asking for.I coild not give a mouth medication because she was spitting all of her bills out.I did try it . I went to the charge nurse and the nursing supervision and they ask and were turned down also.The other part of this is can I claim unemploment or is there a limit to the time I can file.Lets said WC wants to stop paying now can I applied for.Do I have to wait for WC to stop paying me to file for SSI.
Expert:  AlexiaEsq. replied 10 months ago.
When you speak to the WC attorney, try to make sure he/she practices negligent personal injury law as well - usually they do - that way the same practice can do both, well. This could possibly be a PI case as well.

Unemployment insurance benefits are generally only available to those that are willing and able to work - so if you are so impaired you can not work, you would not be eligible for UI. And yes, there is a time frame - you need to have earned a certain amount earned during your base period, which is typically the first 4 of the last 5 quarters before you apply for UI. If you are able to work, that will impact your WC case, obviously, but it is what it is - if you can work, I am sure you will be wanting to do that. You will want to discuss all of these issues in depth with your WC attorney.

With regard to SSI - I think you mean Social Security Disability, not SSI (or at least both). No, if you are unable to work at any type of occupation (not just nursing) and you are NOT so working, and you suspect it will last more than 12 months (such disability), you can apply (and likely should). You do NOT have to wait for WC to stop paying. While SSI would likely be a no-go (because it is welfare for the poor, not Social Security Disabilty Insurance benefits), the SSD (Social Security Disability Insurance) does not require indigency, and unearned income doesn't prohibit it. (It is possible, however, that you will be limited to not collecting both WC and SSD in full, since you are limited to a max total (i.e. 80% of your working income), and the overage will not be payable (WC may have a lien back for those double payment months, to keep you within that 80%). But it never hurts to get both, it can only help.

I hope this helps! My goal is to provide you with excellent and accurate service – if you feel you have gotten anything less, please reply back, I am happy to address follow-up questions. Kindly rate me "excellent" when you are done. I look forward to assisting you in the future, should you have legal questions.

Sincerely,

Alexia Esq.

Customer: replied 10 months ago.

I forgot to ask about the long term disability you mentioned.I did have it when I was working. Can I apply now or wait until WC is over or did I lose that benefit when I got let go?The most important question is when should I get an attorney?Alexia is there any thing more you can tell me to help with the problem I am having?

Expert:  AlexiaEsq. replied 10 months ago.
Hi again, and happy Sunday to you.

(Any questions for legal information pertaining to LTD policies or other area of law other than the question posed in this particular transaction, I ask that you start a new transaction thread, so we can be sure to maintain the integrity of this one. You may, of course, ask for me by expressly stating that you are "reserving this question for Alexia Esq." and generally, that is respected by most professionals on this site.

As for your additional questions here, I will touch on them so you need not re-post them - as they are not time intensive:

I forgot to ask about the long term disability you mentioned.I did have it when I was working. Can I apply now or wait until WC is over or did I lose that benefit when I got let go? That will all depend on your policy - i.e. when you need to have made a claim, so check it out. Check your policy - what defines one as "disabled" differs depending on what policy terms were purchased and paid for with the premiums.

The most important question is when should I get an attorney? If they are not taking care of business to your satisfaction now, I'd consult with one now - if you are not SURE that they are providing for you appropriately, again, consult with one now, in my opinion.

Alexia is there any thing more you can tell me to help with the problem I am having? No, since I don't know the details of your file and can't, since I am not your attorney and am not permitted to give legal advice, only pertinent legal information. But if you have specific legal informational question needs in the future on this that you can specify, by all means, do ask for me and I am happy to help in any way possible. Please do, however, consider the information above as it may relate to your situation and help direct you in your best interests.

I hope this helps! My goal is to provide you with excellent and accurate service – if you feel you have gotten anything less, please reply back, I am happy to address follow-up questions. Kindly rate me "excellent" when you are done. I look forward to assisting you in the future, should you have legal questions.

Sincerely,

Alexia Esq.

AlexiaEsq., Managing Attorney
Category: Employment Law
Satisfied Customers: 11569
Experience: 19+ Years of Legal Practice in the Employment law arena.
AlexiaEsq. and 6 other Employment Law Specialists are ready to help you
Customer: replied 10 months ago.


I am glad you cked in. I do had more questions.

Expert:  AlexiaEsq. replied 10 months ago.
Hi Lillian, please feel free to start a new post transaction with any new matters that could use some legal information. You can ask for me in the post itself by directing that it is only to be answered by Alexia Esq., and that usually works. Now, I am in the middle of a Cancer Relay Walk (fundraiser) out here which doesn't end til 10 a.m. and I am not sure if I will get another break to check back in with you until after that. But, I will try. And if not, later in the day.

Have a great weekend. Time for me to get my back up sneaks on!
Sincerely,
Alexia
Customer: replied 10 months ago.


Frist thank you for your time in the race. I was a cancer nurse for 18 years and I know the people the are effected by this unforgiving disease are very grateful to you.I think WC is about to make me an offer.Do I have to except any offer or can I stay on WC and receive bi weekly ck..If I have to except an offer how do I know what the price should be?How about health coverage for the injury I did receive is that available to me from them.

Expert:  AlexiaEsq. replied 10 months ago.

Hi again Lillian, and thank you for your kind words. Working in the oncology field, you are on the front lines, so I thank YOU for all you have done.

Usually, your WC pay will end when you are either improved enough to go back to work or if not, if you have reached maximum medical improvement. If the latter, that is when one typically then seeks a disabilitiy settlement. If you don't accept what the WC carrier offers (if anything), then you must pursue it in court. So, no, you need not accept an offer, but they don't have to keep paying you either, if you are no longer eligible for WC. The only way to know if you are getting a fair offer is to study the WC cases and law in your state, or, even better, hire an expert, a WC attorney.

And yes, your medical bills related to the WC injury are to be covered by the WC carrier, so you want to make sure that happens with any settlement. Medicare is also implicated, so you will want to make sure your WC lawyer arranges for the Medicare set off. It is complicated, as you can see. I don't suggest you do it on your own, because short of a LOT of course work learning it all, I can't imagine you wouldn't hurt yourself due to what you don't know, that you don't know you don't know. (Tongue twister, lol).

 

I hope this helps! My goal is to provide you with excellent and accurate service – if you feel you have gotten anything less, please reply back, I am happy to address follow-up questions. Kindly rate me "excellent" when you are done. I look forward to assisting you in the future, should you have legal questions.

 

Sincerely,

Alexia Esq.

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